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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Right renal agenesis, ectopia, or anterior nephrectomy can be identified by a characteristic malposition of the right colon. Barium enemas show that the posterior portion of the right colic (hepatic) flexure occupies the area of the right renal fossa. This change in position of the right colon was not observed as a normal variant in 100 randomly selected patients but was present in each of eight patients with agenesis, ectopia, or anterior nephrectomy. This malposition should not be mistaken for internal hernia, malrotation, or displacement by tumor mass or organomegaly. Nonvisualization of the right kidney on excretory urography with normal position of the colon excludes agenesis or ectopia as diagnostic considerations.
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PMID:Malposition of the colon in right renal agenesis, ectopia, and anterior nephrectomy. 41 Feb 48

Intrapericardial diaphragmatic hernia (IDH) is the rarest type of adult diaphragmatic hernia. Only 28 cases have been reported. Indirect blunt trauma has been implicated in most cases, but one resulted from a stab wound to the anterior chest. Patients presented immediately or up to 20 years following trauma with symptoms of intermittent bowel obstruction, including one with strangulation, or cardiac dysfunction, including dyspnea, palpitations, and two patients with cardiac tamponade. Physical findings included bowel sounds in the chest, decreased heart and lung sounds, and an absent point of maximal cardiac impulse. Chest roentgenography usually revealed supradiaphragmatic gas shadows suggestive of bowel in the chest. Thorough examination of both anteroposterior and lateral chest roentgenograms and barium gastrointestinal series may provide positive diagnosis of anterior diaphragmatic hernia, and fluoroscopy after induced pneumoperitoneum may establish its pericardial involvement. Celiotomy is the preferred approach to surgical repair of IDH. Since the symptoms referable to adult IDH can be incapacitating or life threatening, herniorrhaphy should be performed promptly upon diagnosis, with expectation of an uneventful recovery and negligible recurrence rate.
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PMID:Intrapericardial diaphragmatic hernia in adults. 42 68

Right paraduodenal hernias are a relatively rare congenital malformation with a total of 50 clinical cases having been reported. This anomaly can be seen as total encapsulation of the small bowel or a single loop within a hernia sac. Symptoms are often chronic vague abdominal pain and intermittent obstructive episodes. Barium studies in patients with moderate and large defects, and angiography in small hernias may provide the diagnosis. The method of repair is dependent on the size of the hernia encountered. The management of two patients with this problem is described.
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PMID:Right paraduodenal hernia: a source of chronic abdominal pain in the adult. 48 40

The rising number of traffic accidents increases the number of traumatic ruptures of the diaphragm. Often there are no characteristic symptoms or those of other injuries may dominate. Sometimes a long time elapses before signs of hernia appear. Therefore the mass X-ray screening of the population is very important to demonstrate such cases. Chest X-ray, barium meal and pneumoperitoneum are required to detect a late herniation. Prompt surgical repair will give patients the best chance of recovery, thus avoiding complications which greatly increase the mortality rate.
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PMID:[Chronic traumatic rupture of the diaphragm (author's transl)]. 49 57

The writers report a clinical series of 50 patients with traumatic diaphragmatic hernia. There were 36 hernias on the left side and 14 on the right. Stab or bullet wound was the cause of the hernia in 27 cases. The other 23 cases were due to traffic accidents or other blunt injuries. Immediate operative repair was done in 30 cases; in 20 cases the operation was carried out after a time interval of 11.5 years post trauma on an average. Plain chest X-ray, barium meal or enema and pneumoperitoneum were the most valuable diagnostic tools. Visceral injuries were discovered in 53% of cases caused by traffic accidents. The omentum, stomach, colon and spleen were the organs most frequently herniated. In two cases perforation of the stomach occurred before the operation. There were three cases of pericardial rupture associated with the diaphragmatic hernia in the series. The repair was done via thoracotomy in 28 cases, via laparotomy in 4 cases; and both thoracotomy and laparotomy were carried out in 18 cases. The hospital mortality was 2%. One of the patients died of peritonitis and renal failure following perforation of the stomach and intestines on the 9th postoperative day. Recurrence of the hernia occurred twice in one case. Re-examination revealed striction of the diaphragmatic movement in 11 cases. The clinical features, diagnosis and operative treatment are discussed.
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PMID:Traumatic diaphragmatic hernia. Report of 50 cases. 59 96

A series of 58 cases of traumatic diaphragmatic hernia following blunt and penetrating injury is reviewed. The problems of radiodiagnosis are outlined and the need for barium contrast studies of the entire gastrointestinal tract to ensure recognition of isolated small bowel herniation is emphasized. Surgical access via laparotomy is recommended in the immediate post-traumatic presentation, whereas thoracotomy is preferable in cases diagnosed after a latent interval. Penetrating injury resulted in smaller diaphragmatic defects, greater morbidity and higher mortality due mainly to infective complications.
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PMID:Traumatic diaphragmatic hernia. 62 29

In a 1973 study of 200 aged patients with groin hernias, a comparatively high incidence of the type known as sliding hernia was noted. The present study of 60 patients over age 70 seen at the Henry Ford Hospital between the years 1940 and 1972 was devoted specifically to the problem of sliding hernias. The threat of bowel strangulation is often advanced as a reason for the operative repair of such hernias, but this complication is rare. Bowel dysfunction, constipation and local discomfort are far more common, and gave rise to annoying symptoms in 75 percent of the patient studied. Barium enema x-ray examinations often revealed some degree of bowel obstruction. Most often the sigmoid colon the left side and the ileocecal segment on the right side constituted the sliding components of the hernia; the bladder was involved less often. Repair of 62 sliding hernias in 60 patients was performed successfully. There were no deaths, and only one recurrence of the hernia.
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PMID:Sliding inguinal hernia in patients over 70 years of age. 62 87

A symptomatic hernia (most inguinal or femoral hernia, seldom epigastric, umbilical or post-operative hernia)--appeared a little while ago--originates from a preexisting, so far unknown or long since known illness. All patients with a hernia--especially those over 40 years old--are to be carefully asked for preexisting illnesses. Barium-enema and rectoscopy are not indicated at each inguinal or femoral hernia as a screening-method to exclude a symptomatic hernia; however, both methods must be employed in suspicious cases. 320 Patients with a histologically verified carcinoma of the rectum and colon had no inguinal or femoral hernia. From 387 patients with an inguinal or femoral hernia 318 patients were over 40 years old; at these patients polyps were found in five cases by rectoscopy, but never by barium-enema, and two carcinoma of the colon transverse appeared by barium-enema. A 23-years old patient with a great intraabdominal malignant tumor must be added to the sum total.
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PMID:[Symptomatic hernia (author's transl)]. 62 60

Five cases presenting in late infancy and childhood with symptoms and signs referable to malrotation of the midgut are described. The condition may present with jaundice, malabsorption or the signs and symptoms of intestinal obstruction due to internal hernia or volvulus. It may also result in volvulus and gangrene of the midgut. A short root of the mesentery predisposing to this event will be seen on a barium meal and follow through examination and will warn of its impending occurrence.
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PMID:The misplaced caecum and the root of the mesentery. 65 37

Twenty-five patients with traumatic diaphragmatic hernia discovered at least five months after injury are described, of whom 18 were male and seven female. All but one hernia occurred on the left side. Stab wounds were the etiological factor in 22 patients and blunt trauma in three. The diagnosis was most often made by a chest or abdominal radiograph, but barium ingestion confirmed the diagnosis in ten patients. Intercostal drainage of gastric contents provided the diagnosis in two patients. In all nine patients initially approached by a thoracotomy or a thoracoabdominal incision, the hernia was easily reduced and the defect repaired. Although reduction and repair were easily accomplished by the abdominal route in seven patients, this approach was unsatisfactory or inadequate in six others. The colon and stomach were usually in the chest, and strangulation occurred in five patients. The mortality was 20% but rose to 80% when gangrene was present.
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PMID:Delayed presentation of traumatic diaphragmatic hernia. 68 90


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